Editing Digoxin (section)

==Digoxin and cancer==
Cardiac glycosides, particularly digoxin, have been conventionally used for treatment of common cardiac problems, mainly heart failure and cardiac arrhythmias. The interaction of digoxin and cancer has also been studied. Despite existence of numerous preclinical studies that investigated the anticancer effects of digoxin, there are no solid and conclusive results so far. 

Several studies have suggested that digoxin may have anticancer properties,<ref>{{cite journal | vauthors = Yokoyama S, Sugimoto Y, Nakagawa C, Hosomi K, Takada M | title = Integrative analysis of clinical and bioinformatics databases to identify anticancer properties of digoxin | journal = Scientific Reports | volume = 9 | issue = 1 | pages = 16597 | date = November 2019 | pmid = 31719612 | pmc = 6851125 | doi = 10.1038/s41598-019-53392-y | bibcode = 2019NatSR...916597Y }}</ref> others not.<ref>{{cite journal | vauthors = Kaapu KJ, Murtola TJ, Talala K, Taari K, Tammela TL, Auvinen A | title = Digoxin and prostate cancer survival in the Finnish Randomized Study of Screening for Prostate Cancer | journal = British Journal of Cancer | volume = 115 | issue = 11 | pages = 1289–1295 | date = November 2016 | pmid = 27755533 | pmc = 5129833 | doi = 10.1038/bjc.2016.328 }}</ref>

Digoxin, as a cardiac glycoside, has a chemical structure basically similar to that of [[estradiol]]. Digoxin has the ability to bind oestrogen receptors, and therefore it has been proposed that it might increase the risk of oestrogen-sensitive breast and uterine cancers.<ref>{{cite journal | vauthors = Biggar RJ, Wohlfahrt J, Oudin A, Hjuler T, Melbye M | title = Digoxin use and the risk of breast cancer in women | journal = Journal of Clinical Oncology | volume = 29 | issue = 16 | pages = 2165–70 | date = June 2011 | pmid = 21422417 | doi = 10.1200/JCO.2010.32.8146 | doi-access = free }}</ref> A large Danish study found a complicated picture, with slightly increased risk of breast cancer amongst women taking digoxin, but better prognostic features.<ref>{{cite journal | vauthors = Biggar RJ, Andersen EW, Kroman N, Wohlfahrt J, Melbye M | title = Breast cancer in women using digoxin: tumor characteristics and relapse risk | journal = Breast Cancer Research | volume = 15 | issue = 1 | pages = R13 | date = February 2013 | pmid = 23421975 | doi = 10.1186/bcr3386 | pmc = 3672748 | doi-access = free }}</ref> The Nurses' Health Study found a similar slight increase of risk.<ref>{{cite journal | vauthors = Ahern TP, Tamimi RM, Rosner BA, Hankinson SE | title = Digoxin use and risk of invasive breast cancer: evidence from the Nurses' Health Study and meta-analysis | journal = Breast Cancer Research and Treatment | volume = 144 | issue = 2 | pages = 427–35 | date = April 2014 | pmid = 24573543 | pmc = 4010120 | doi = 10.1007/s10549-014-2886-x }}</ref>

Digoxin inhibits the proliferation of many cancerous cell lines ''in vitro'',<ref>{{cite journal | vauthors = Deng K, Shen J, Wang W, Li M, Li H, Chen C, Zhao H, Zhang M, Xue T, Liu Q, Lui VW, Hong B, Lin W | display-authors = 6 | title = Sodium chloride (NaCl) potentiates digoxin-induced anti-tumor activity in small cell lung cancer | journal = Cancer Biology & Therapy | volume = 20 | issue = 1 | pages = 52–64 | date = 2019-01-02 | pmid = 30183476 | pmc = 6343689 | doi = 10.1080/15384047.2018.1504723 }}</ref><ref name="Chung 44203–44216">{{cite journal | vauthors = Chung MH, Wang YW, Chang YL, Huang SM, Lin WS | title = Risk of cancer in patients with heart failure who use digoxin: a 10-year follow-up study and cell-based verification | journal = Oncotarget | volume = 8 | issue = 27 | pages = 44203–44216 | date = July 2017 | pmid = 28496002 | pmc = 5546474 | doi = 10.18632/oncotarget.17410 }}</ref> but its relevance to cancer ''in vivo'' remains unclear.